Organization
SELECT REFERENCE LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ANDREW MOORE (SENIOR ACCOUNTANT)
(336) 235-0750
Entity
Organization
Contact information
Practice address
1100 REVOLUTION MILL DR, SUITE 1, GREENSBORO, NC 27405-5067
(336) 510-1120
Mailing address
1100 REVOLUTION MILL DR, SUITE 1, GREENSBORO, NC 27405-5067
(336) 510-1120
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34D2091857
CLIA
NC
Enumeration date
10/20/2016
Last updated
10/20/2016
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